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NPI Code Detail

MEDICARE: MICHELLE CARPENTER-BRADLEY MD

MEDICARE: MICHELLE CARPENTER-BRADLEY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician160634-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669474854
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE CARPENTER-BRADLEY MD
Provider Business Mailing Address
First Line : 1555 LONG POND RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14626-4122
Country : US
Telephone Number : 585-723-7870
Fax Number : 585-723-7871
Provider Business Practice Location Address
First Line : 1555 LONG POND RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14626-4122
Country : US
Telephone Number : 585-723-7870
Fax Number : 585-723-7871
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 05/07/2021

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